Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Roger T Moore, MD

Individual provider Dermatology Physician · NPI 1366408080

Roger T Moore, MD is a Dermatology in Elkhart, Indiana. Graduated from Texas Tech University Health Science Center School of Medicine in 1999, 27 years ago. Practices with Dermatology and Skin Surgery Center, a 27-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
27
Trained at
Texas Tech University Health Science Center School of Medicine
Licensed in
IN
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

111 N Nappanee St
Elkhart, IN 46514-1957
Phone: (574) 522-0265
Fax: (574) 293-2855
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 01058554A (IN)

Record details

NPI number1366408080
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 21, 2006
Last updated in NPPESJuly 8, 2007
Mailing address111 N Nappanee Street, Elkhart, IN 46514

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolTEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduated 1999 (27 years in practice)
Group practice Dermatology And Skin Surgery Center — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount